Masi Gabriele, Pari Cinzia, Millepiedi Stefania
IRCCS Stella Maris Scientific Institute for Child Neurology and Psychiatry, Via dei Giacinti 2 56018 Calambrone (Pi), Italy.
Expert Opin Pharmacother. 2006 Apr;7(5):545-54. doi: 10.1517/14656566.7.5.545.
Although panic disorder usually emerges in early to middle adulthood, adults with panic disorder often retrospectively report that their panic symptoms began in childhood or early adolescence. The majority of these juvenile cases are being misdiagnosed, and/or do not come to clinical attention. Awareness of early-onset panic disorder, as well as a more precise definition of early signs and possible clinical subtypes, can favour timely diagnosis and treatment, reduce clinical impairment and improve the prognosis of these patients. In the context of a multimodal approach, pharmacological treatment can be helpful. This review focuses on the empirical evidence of pharmacotherapy in early-onset panic disorder, including selective serotonin re-uptake inhibitors, benzodiazepines and tricyclics. The data supporting efficacy are still limited, and no controlled studies are available. Practical guidelines for the management of these patients are provided, including treatment of the most frequent psychiatric comorbidities.
尽管惊恐障碍通常在成年早期至中期出现，但患有惊恐障碍的成年人常常回顾性地报告称，他们的惊恐症状始于童年或青春期早期。这些青少年病例中的大多数都被误诊，和/或未引起临床关注。认识到早发性惊恐障碍以及对早期症状和可能的临床亚型进行更精确的定义，有助于及时诊断和治疗，减少临床损害并改善这些患者的预后。在多模式治疗方法的背景下，药物治疗可能会有所帮助。本综述聚焦于早发性惊恐障碍药物治疗的实证证据，包括选择性5-羟色胺再摄取抑制剂、苯二氮䓬类药物和三环类药物。支持疗效的数据仍然有限，且尚无对照研究。本文提供了这些患者的实用管理指南，包括对最常见精神共病的治疗。
